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Individual

MARY D. VINCITORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., L.C.P.C

Contact information

Practice address
107 E MAPLE RD, LINTHICUM, MD 21090-2513
(410) 615-2387
Mailing address
456 KINGWOOD RD, LINTHICUM, MD 21090-1922
(410) 615-2387

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC2165
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19MVMA
CARE FIRST, BCBS
MD
01
53450001
GHMSI
MD
Enumeration date
01/28/2007
Last updated
07/08/2007
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